96138 with Medicare (national): what the policy says
The short answerYes. 96138 is active on the 2026 fee schedule for technician-administered testing, with a national non-facility rate that computes to $37.74 for the first 30 minutes. It carries no work RVU and is on the telehealth list.
By Javier Alvarez · Updated · 1 min read
1 row: Medicare. Public policy, not the member's benefits.
Medicare (national)
Original Medicare Part B, Physician Fee Schedule and Benefit Policy Manual · All states
| 96116 | Listed (neurobehavioral status exam, first hour (active on the 2026 PFS)) [1] |
|---|---|
| 96121 | Listed (add-on, each additional hour (active on the 2026 PFS)) [1] |
| 96130 | Listed (psychological testing evaluation, first hour (active on the 2026 PFS)) [1] |
| 96131 | Listed (add-on, each additional hour (active on the 2026 PFS)) [1] |
| 96132 | Listed (neuropsychological testing evaluation, first hour (active on the 2026 PFS)) [1] |
| 96133 | Listed (add-on, each additional hour (active on the 2026 PFS)) [1] |
| 96136 | Listed (test administration and scoring by the clinician, first 30 minutes (active on the 2026 PFS)) [1] |
| 96137 | Listed (add-on, each additional 30 minutes (active on the 2026 PFS)) [1] |
| 96138 | Listed (test administration and scoring by a technician, first 30 minutes (active on the 2026 PFS)) [1] |
| 96139 | Listed (add-on, technician, each additional 30 minutes (active on the 2026 PFS)) [1] |
| 96146 | Listed (single automated instrument, automated result only (active on the 2026 PFS)) [1] |
| Where it applies | Testing is paid as a diagnostic test under section 1861(s)(3) of the Social Security Act. Incident to billing is not authorized for these tests. Diagnostic testing is outside the outpatient mental health treatment limitation. [2] |
| Telehealth rules | Codes 96116, 96121, 96125, 96130 to 96133 and 96136 to 96139 are on the CY 2026 final list of Medicare telehealth services. We did not find 96146 on that list. Through December 31, 2027, patients can receive Medicare telehealth services anywhere in the United States and territories. [3][4] |
| Who can bill | Clinical psychologists, independently practicing psychologists (with a physician order), NPs, CNSs and PAs within state scope, and physicians. A psychologist on an institution's staff does not bill; the institution does. An independent psychologist who is not a clinical psychologist must put the ordering physician's name and address on the claim. [2] |
| Payment | 2026 national payment computed from the published RVUs times the $33.4009 conversion factor (non-QPP file), non-facility rate: 96130 $123.92, 96131 $86.51, 96132 $122.25, 96133 $97.86, 96136 $43.76, 96137 $37.07, 96138 $37.74, 96139 $35.40, 96146 $2.34. Facility rates for 96130, 96132 and 96136 are $99.53, $98.53 and $21.38. Local rates vary by GPCI. [1] |
| Also | The manual says there is no payment under the fee schedule for services performed by students or trainees. A trainee being present while a licensed clinician tests does not stop the clinician from billing. The manual text still names the pre 2019 code numbers. [2] |
- CMS: CY 2026 Physician Fee Schedule relative value file RVU26D (PPRRVU2026_Oct_nonQPP.csv, conversion factor 33.4009), checked October 30, 2026
- CMS: Medicare Benefit Policy Manual (100-02) Chapter 15, section 80.2 Psychological Tests and Neuropsychological Tests, checked October 30, 2026
- CMS: List of Telehealth Services, CY 2026 PFS final list, checked October 30, 2026
- CMS: Telehealth FAQ (updated 10/8/26), checked October 30, 2026
What Medicare (national)'s policy says about 96138
96138 is the CPT code for psychological or neuropsychological test administration and scoring by technician, first 30 minutes. At Medicare (national) it is listed: named in the payer's public policy. Each line below is from the cited text:
- Where it is listed. Active on the 2026 physician fee schedule (status A). Psychological or neuropsychological test administration and scoring by technician, first 30 minutes. (CMS, checked October 30, 2026)
- Who can bill it. Technician-administered testing is allowed; LCDs such as WPS require the technician to be directly supervised by the provider. Students and trainees are not paid under the fee schedule. (CMS Medicare Coverage Database, checked October 30, 2026; CMS, checked October 30, 2026)
- Telehealth. On the CY 2026 final list of Medicare telehealth services (action: Maintain). (CMS, checked October 30, 2026)
- Payment. 2026 national payment computed from RVUs times the $33.4009 conversion factor: $37.74 non-facility (1.13 RVUs). Work RVU 0.00; the file flags the facility practice expense indicator NA. (CMS, checked October 30, 2026)
96138 at other payers
The rest of Medicare (national)'s psychological testing rules
The Medicare (national) row has its codes, telehealth rule, limits and authorization, each with its source. Other codes we checked at Medicare (national): 96130, 96132, 96136 and 96146. Before the claim goes out, compare it with the row in the table above.